Objective To explore the preliminary experience of a one-stage hybrid operating room (OR) in cerebrovascular surgery.Methods A total of 23 patients [9 male,mean age:(40.0±11.2) years] underwent one-stage hybrid approach in a hybrid OR from September 2012 to December 2013,were chosen in our study.Craniotomy and percutaneous intervention of these patients were performed in a single session.Their clinical data were retrospectively analyzed.Results Thirty-one times of digital subtraction angiography (DSA) was performed in all patients,and 15 patients were diagnosed as having intracranial aneurysms and 8 arteriovenous malformations (AVMs).In one patient,a reposition of the clip was needed due to neck remnant after clipping.Residual nidus resection was done in 2 patients with AVMs.Temporary balloon occlusion happened in 5 patients,parent artery occlusion in 3,and 8 accepted emergency surgery under DSA confirming cerebrovascular diseases and removing hematoma.No procedural complications was observed.Conclusion A combined endovascular and surgical approach conducted in a one-stage hybrid OR provides a new strategy for the treatment of complex and emergency cerebrovascular diseases.